Loren Deidre Lyons, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

420939 Issued in NY

Practice address

100 S Jersey Ave Unit 16
Setauket, NY 11733-2036

Phone

(631) 689-6400

NPI assigned

Dec 28, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Square Care Medical Group, LLP

  • Obstetrics & Gynecology Physician
  • Woodbury, NY
  • NPI 1457392763
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1053641928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE STE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905114",
            "telephone_number": "516-226-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE UNIT 16",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117332036",
            "telephone_number": "631-689-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Sills Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724869",
            "country_code": "US",
            "telephone_number": "631-447-1032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "LOREN",
        "middle_name": "DEIDRE",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "420939",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "420939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Logan, LMSW
• Long Island Digestive Disease Consultants, P.C. (Long Island Endoscopy Center)
• Long Island Optometry Care, PLLC
• Sirka Louca, LCSW-R
• Brian Ludwig
• Li Ma, DDS
• Katherine Macdevitt, R.N
• Randolph Joshua Malsky
• Crista Elizabeth Maracic, PHD
• Sandra Temple Marinelli, DC

• Women's Health Nurse Practitioner in Setauket, NY
• Providers in Setauket, NY by specialty
• Women's Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.